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Organization
WESTSIDE PREMIER MED GRP
Active
Organization
WESTSIDE PREMIER MED GRP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM AMMERMAN (ADMINISTRATOR)
(760) 949-1489
Entity
Organization
Contact information
Practice address
17330 BEAR VALLEY RD STE 105, VICTORVILLE, CA 92395
(760) 245-8182
(760) 245-2123
Mailing address
17330 BEAR VALLEY RD STE 105, VICTORVILLE, CA 92395
(760) 245-8182
(760) 245-2123
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
DC21523
CA
111N00000X
Chiropractor
Primary
DC27666
CA
207X00000X
Orthopaedic Surgery Physician
A36514
CA
Other
Enumeration date
01/31/2007
Last updated
09/11/2025
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